Continuous oscillation therapy improves the pulmonary outcome of intubated newborns: results of a prospective, randomized, controlled trial

Abstract

Objectives: To determine the effects of continuous postural changes produced by an oscillating bed on cardiopulmonary function and on the duration of endotracheal intubation and oxygen supplementation with large premature and term infants.

Design: A prospective, randomized, controlled trial.

Setting: Neonatal intensive care unit.

Patients: Nineteen 1-day-old newborns weighing > 1500 g with various respiratory diseases.

Interventions: The treatment group received continuous postural therapy on an oscillating bed; the control group received conventional frequency of manual postural changes. Both groups received physiotherapy. Patients were studied until they were extubated and oxygen supplementation was stopped.

Measurements and main results: Selected cardiopulmonary variables and ventilator settings during the first 6 hrs of study and the overall duration of endotracheal intubation and oxygen supplementation were determined. Oscillation therapy significantly decreased the duration of oxygen supplementation and had no adverse effects on cardiopulmonary variables. In a subgroup of infants with respiratory distress syndrome from prematurity or asphyxia, oscillation therapy also significantly shortened the duration of oxygen supplementation; a trend toward reduced duration of intubation was observed.

Conclusions: Continuous postural changes using an oscillating bed reduced the duration of oxygen supplementation in infants with various respiratory disorders. Furthermore, this oscillation therapy was not associated with adverse cardiopulmonary or thermal complications.